I am 67 years of age and have a $20,000 pension. The social-security payments my wife and I receive total $9,400. Our income from interest on savings and dividends amounts to approximately $12,000 a year. We have no debts. Yet in a year or so I could be virtually penniless, living on an allowance similar to that given to welfare recipients. My wife is in a nursing home. About 15 years ago I learned that my wife had Parkinson's disease. This condition triggered other problems, and four years ago a massive internal infection necessitated the removal of most of her small intestines. A chronic bladder problem and unusually low blood pressure required that she take extremely large doses of medication. Because of her weakened condition she required constant assistance with even ordinary chores, such as going to the bathroom or dressing. Then, three months ago, she suffered a stroke. Her speech is still for the kind of care my wife receives are more or less standard in most major cities. Some institutions are even more expensive. Other than Medicaid (government insurance for the impoverished) there is practically no insurance that covers extended care in a nursing home. Medicare will pay most nursing-home expenses for up to a hundred days, but only under certain conditions: if the patient must be fed and medicated intravenously, suffers from bedsores, is kept on blood-thinning medication or requires throat-suctioning. The catch is that most nursing homes will not admit such a person to their custody. If I were a murderer my pension could not be touched, but having a sick wife carries a unintelligible and the state of her health special penalty. is such that she can no longer be cared for at home. Paid Help: We have been married 35 years and in all that time have never been separated. Even after her intestinal operation she had refused to go to a convalescent home and insisted on coming home to me. For my part, I was more than willing to have her. We were forced to take in paid help costing close to $400 a week but, still, I was on my own nights and weekends, doing laundry, shopping, preparing meals, cleaning our small apartment, seeing that she took all her medicine, attending to her every need. I was seldom able to sleep more than an hour at a stretch. Since the stroke, however, my wife requires even more skilled and timeconsuming care, which can best be provided in a nursing home. The cost is $105 daily, roughly $3,200 a month or $38,325 a year, which is more than our entire net income. These charges Once I've spent my savings and disposed of other assets, my wife will be eligible for Medicaid. If there is an alternative to insolvency, I am not aware of it. It is my understanding that I will be allowed to keep $2,600 for myself and $2,600 for my wife, essentially for burial expenses. My pension, earned after 33 years with the New York City Police Department, will be attached. If I were involved in a swindle and owed money, if I were serving time in jail for murder, my pension could not be touched. Having a sick wife carries a special penalty. I will no longer be able to own anything. If I work I won't be able to keep my salary. What I will be allowed is a set amount for rent and food. I will join the ranks of the nonproductive members of society. The odd part of this arrangement is that by making us liquidate our savings, the government is depriving us of the $1,000 a month in bank and dividend interest that could go toward my wife's upkeep. If that income could be retained, the nursing-home cost to Medicaid would be $600 or so a month. Were I permitted to work it would be even less. Instead, it will cost the taxpayers, through Medicaid, more than $1,600 a month. Divorce: The fact is that if I were placing my parent or an incapacitated child in an institution, under the law I would not be financially responsible. A year ago an accountant suggested that since I was neither a millionaire nor a pauper the sensible thing to do was to get a divorce. That way my wife would be entitled to a share of what we own and I would not be left without a cent. Certainly it is logical. But why should we be compelled to do something that is so contrary to the feelings we have for each other? Half of everything a husband has should and does belong to his wife. Why can't the same rule apply for us? Moreover, I believe that half of whatever I might be able to earn should go to her. I would willingly return to work to lighten Medicaid's share of the bill. Why should people who have been together as long as we have, and who feel about each other the way we do, be forced into a divorce? The one bright spot in all this is that I was able to get her placed in a good nursing home where she is well cared for. As long as I've known her, my wife has agonized over the fact that her grandmother, who raised her, ended her life in a charity ward. That was during the Great Depression and thoughts of how things were for her beloved grandmother have always haunted her. I know that whatever happens, even if I am not around, she is in good hands. Now, what about me? David B. Gordon is a retired police officer. He lives in New York City. PREPARED STATEMENT OF JACK RAFFERTY, MAYOR, HAMILTON, N.J. CONGRESSMEN RINALDO AND SMITH, I AM JACK RAFFERTY, MAYOR OF HEARING IS ONE OF VITAL INTEREST TO NOT ONLY ME BUT ALL AMERICANS POSITIVE INCENTIVES TO BE MORE EFFICIENT AND COST CONSCIOUS IN THE PROVISION OF CARE. THIS IS AN ACTION THAT HAS BEEN BADLY NEEDED FOR YEARS, BUT HAS BEEN IGNORED AND OVERLOOKED BECAUSE IT WAS TOO DIFFICULT AN ISSUE TO CONFRONT AND NOT ESPECIALLY POLITICALLY ATTRACTIVE. TO THE EXTENT THAT THIS PORTENDS FUTURE CHANGES THAT MAY BE UNDER CONSIDERATION, I AM TRULY ENCOURAGED. I AM PARTICULARLY CONCERNED, HOWEVER, THAT THE NEEDS OF ALL OUR OLDER AMERICANS BE GIVEN THE THOROUGH AND PROPER CONSIDERATION IN THE COUNCILS IN WASHINGTON THAT THEY RIGHTFULLY DESERVE. THESE PEOPLE, IN THE TWILIGHT OF THEIR YEARS, THE AMERICANS WHO ARE RESPONSIBLE FOR THE GROWTH AND DEVELOPMENT OF THIS GREAT NATION ARE INCREASINGLY FINDING THAT HEALTH CARE IS DEPRIVING THEM OF EVERYTHING THEY HAVE WORKED A LIFETIME ACHIEVING; THAT IS A HAPPY AND COMFORTABLE RETIREMENT. I FIND IT DISMAYING THAT MEDICARE, THE HEALTH CARE PROGRAM FOR THE AGED, SPENDS LESS THAN ONE-HALF OF A BILLION DOLLARS ON INSTITUTIONAL LONG TERM CARE, WHEREAS THE MEDICAID PROGRAM, A PROGRAM FOR THE INDIGENT, SPENDS MANY BILLION OF DOLLARS FOR THE SAME TYPE OF CARE. I FIND THERE ARE OTHER INEQUITIES THAT FROM MY PERSPECTIVE SEEM TO HAVE LITTLE RATIONALE OR JUSTIFICATION. WHY, FOR EXAMPLE, MUST A PERSON BE HOSPITALIZED BEFORE THEY ARE ELIGIBLE FOR NURSING HOME BENEFITS UNDER THE MEDICARE PROGRAM? WHY, ARE THE MEDICARE BENEFITS FOR THOSE GENUINELY IN NEED OF NURSING HOME CARE SO RESTRICTIVE AND LIMITED? WHY IS IT OUR OLDER AMERICANS CANNOT BE SAFEGUARDED AGAINST CATASTROPHIC HEALTH CARE COSTS? I CANNOT BELIEVE THAT A COUNTRY THAT IS CAPABLE OF PUTTING A MAN ON THE MOON IN TEN SHORT YEARS CANNOT REDIRECT THAT SAME CALIBER OF BRAIN POWER TOWARD DEVELOPING A HEALTH CARE SYSTEM THAT WILL PROVIDE QUALITY HEALTH CARE AT A PRICE THAT ALL CAN AFFORD. THE FACT THAT THIS ISSUE IS FINALLY BEING CONFRONTED HEAD ON AND NOT BEING AVOIDED OR SIDE-STEPPED IS A REPRESENTS A CREATIVE, INNOVATIVE AND FARSIGHTED EFFORT. THIS IS NOT A PARTISAN ISSUE AND SHOULD NOT BECOME AN ARENA FOR PARTISAN POLITICS. I DO NOT SPEAK AS A REPUBLICAN OR DEMOCRAT, BUT RATHER AS A CONCERNED ELECTED LOCAL OFFICIAL AND IF MY MESSAGE TO WASHINGTON IS ANYTHING, IT IS THAT AMERICA DOES CARE FOR ITS ELDERLY AND THAT WE ARE LOOKING TO YOU AND YOUR COLLEAGUES IN THE CONGRESS FOR CREATIVE AND INNOVATIVE SOLUTIONS. I, FOR MY PART, AND I AM SURE THAT I SPEAK FOR VIRTUALLY ALL THE MAYORS AND GOVERNORS OF AMERICA, STAND READY TO DO OUR SHARE TO ASSIST YOU IN THIS NOBLE EFFORT IN WHATEVER WAY WE CAN. I APPRECIATE YOU GIVING ME THIS OPPORTUNITY TO SUBMIT TESTIMONY BEFORE YOUR COMMITTEE AND I COMMEND YOU ON SHOWING THE FORTITUDE TO TACKLE THIS MOST DIFFICULT AND TROUBLESOME OF HEALTH POLICY ISSUES. I LOOK FORWARD TO FOLLOWING YOUR PROGRESS IN THIS VITAL AREA. THANK YOU. |